ethanol intoxication) that suggest a precipitating cause for acute hypoglycemia.įollowing completion of the primary survey and associated interventions, immediate diagnostic evaluation should include point-of-care glucose testing and EKG acquisition. The primary survey may further reveal signs of decompensated underlying disease (e.g. diminished Glascow Coma Scale (GCS) score, focal neurologic deficit) may suggest autonomic and cognitive dysfunction, respectively. tachycardia, hypertension) and neurologic disability (e.g. The initial approach to the patient with hypoglycemia begins with the primary survey to reduce the likelihood of death or permanent disability within the minutes-to-hours following initial presentation. The serum glucose level at which symptoms of hypoglycemia occur vary among patients, and may also vary between hypoglycemic events in a given patient however, serum glucose levels < 70 mg/dL are generally considered consistent with hypoglycemia. Hypoglycemia is clinical syndrome of altered autonomic function and impaired cognition that can occur as serum glucose levels fall below normal physiologic thresholds. In diabetic patients, approximately 25% will experience repeated episodes of hypoglycemia. Hypoglycemia accounts for approximately 7% of emergency department visits for altered mental status within the US. Review the disposition of a patient presenting to the emergency department with hypoglycemia.Review the methods of treating a patient with hypoglycemia.Review the signs and symptoms associated with hypoglycemia.The objectives of this module will be to: The patient’s husband asks “Can we go home now?” She has no focal neurologic deficits on exam and has no other pertinent exam findings. Patient is uncertain what happened but thinks that she might have switched her short acting insuling with her long acting. Pt had a resolution of her altered mental state.
Point of care glucose was 42 mg/dL initially. The spouse found the patient unconscious at home. Kenny Banh, MD & Jose Acosta, University of CaliforniaĮdited By: Steven Davis MD, George Washington UniversityįOAMed Contributor: Ryan McLaughlin, MD, Virginia Commonwealth UniversityĪ 68-year-old female who is a known diabetic on insulin detemir (Levemir) at home is brought in by EMS for a hypoglycemic event. SAEMF/CDEM Innovations in Undergraduate Emergency Medicine Education GrantĬareer Development and Mentorship CommitteeĬommunications and Social Media Committee Presidential Address: Where Do We Go From Here?ĮMF/SAEMF Medical Student Research Training Grant Virtual Rotation and Educational ResourcesĬommittee Update: NBME EM Advanced Clinical Examination Task Force Visit us on Twitter LinkedIn Facebook YouTubeĮffective Consultation in Emergency Medicine Video
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